A number of parameters or compounds define the nutritional status of a subject. For example, nutrients, micronutrients, and other compounds are found in certain concentrations in a fluid or tissue of the subject. A number of diseases change the concentrations of these compounds or values of these parameters, due to increased utilization of these compounds to fight against the disease, metabolic changes, and/or suboptimal dietary management of the patient. As a result the subject suffering from such a disease is malnourished because the relevant parameters and compounds are no longer in the range found in a healthy subject and lead to nutritional deficiencies, like improper provision of structural components, insufficient energy supply, or a lack of functional components. Thus, the subject suffering from a disease affecting the nutritional status can benefit from a nutritional intervention addressing the distinctive nutritional requirements of said subject. Providing the subject with a nutritional composition comprising nutrients and micronutrients in amounts that reestablish the metabolic, physiologic and functional equivalence of the nutritional status of a healthy subject would therefore be required.
A particular example of such a disease where the subject exhibits distinctive nutritional requirements is inflammatory bowel disease (IBD).
The role of nutrition in IBD gathers high interest, especially in pediatric Crohn's Disease (CD), where studies have shown that exclusive enteral nutrition (EEN) can induce remission in mild to moderate disease comparable to corticosteroids. Thus, nutritional interventions offered in addition to the standard of care (SoC) are an appealing option for a safe long-term disease management. Malnutrition is common in pediatric and adult patients with IBD, especially in those with CD, and typically manifests as protein-energy deficit yielding to general weight loss, and/or vitamin/mineral deficiencies. In general, poor dietary intake secondary to postprandial abdominal pain and diarrhea is the most common cause of malnutrition in IBD. The degrees of malnutrition depend on the duration, severity and extend of the disease, as well as loss of function due to bowel resection or fibrosis. IBD patients have also been reported to have fat and muscle mass depletion; and micronutrient deficiencies also occur with mild disease or in remission phase.
Beyond malnutrition associated nutrient deficiencies, nutrition is also considered as an effective approach to the maintenance of the remission phase and particularly to maintain the mucosal health. Intestinal mucins forming the mucus gel and protecting the intestinal epithelium have been suggested of crucial importance to restore epithelial health after mucosal injury in IBD. The body capacity to maintain adequate mucin synthesis is directly related to the bioavailability of some specific amino acids. Intestinal inflammation is known to increase gastrointestinal threonine uptake and mucin synthesis in enterally fed minipigs. Therefore, under inflammatory conditions as in IBD, specific amino acids could become conditionally essential to sustain mucin synthesis justifying thus for their nutritional specific enrichment.
Accordingly, there is the need for a method identifying the distinctive dietary needs of patients suffering from a disease(s) or clinical condition, with a nutritional status that is different from the nutritional status of a healthy subject.